25G PPV combined with IOL ciliary sulcus suture, fixation and replacement in the treatment of IOL capsule bag complex dislocation in the vitreous cavity

AIM:To evaluate the clinical effect of 25G pars plana vitrectomy(PPV)combined with intraocular lens(IOL)ciliary sulcus suture fixation and replacement of IOL capsular bag complex.METHODS: A retrospective analysis of 21 patients(21 eyes)in our hospital who applied 25G PPV combined with IOL ciliary sulcus suture and fixation replacement in our hospital from January 2015 to January 2020 to treat the IOL capsular complex completely detached from the clinical data.RESULTS: All the cases were successfully removed the dislocated IOL complex during the operation. There was no iatrogenic retinal damage. During the operation, 4 cases(4 eyes)were found to have the retina hole, 2 cases(2 eyes)were found to be retinal lattice degeneration area, which were treated with laser photocoagulation of the retina. Follow-up for 6-18mo, best corrected visual acuity(BCVA)(LogMAR)increased from 0.40±0.30 before operation to 0.33±0.25 after operation(P=0.040). The BCVA at the last follow-up of all cases reached the BCVA before surgery. The absolute value of the difference between the postoperative spherical equivalent power and the preoperative IOL refractive power prediction value is less than or equal to 0.75D. At the last follow-up, the position of the intraocular lenses in all cases was good, and there were no complications such as retinal detachment. CONCLUSION: The technique of 25G PPV and the exchange of IOL ciliary sulcus fixation with intraocular IOL capsule complex is a safe and effective procedure for dislocation of IOL-capsular bag complex entirely into the vitreous cavity.